A Case of Venous Anomaly of Diploic Origin Successfully Treated by Preoperative Direct Puncture Sclerotherapy

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Objective: One case of venous anomaly arising from the cranium in which intraoperative hemorrhage could be effectively controlled by direct puncture sclerotherapy using N-butyl-2-cyanoacrylate (NBCA) is reported.

Case Presentation: A 76-year-old male noted gradually progressing right exophthalmos and swelling of the right temporal region and was found by imaging studies to have a space-occupying lesion extending inside and outside the cranium and in the orbit. On diagnostic biopsy of the extracranial part under local anesthesia, massive and spouting venous hemorrhage was observed. From intraoperative and pathological findings, a diagnosis of venous anomaly was made, and sclerotherapy was performed using NBCA under direct percutaneous puncture. After 4 days, the lesion could be resected totally with only slight bleeding.

Conclusion: Sclerotherapy using NBCA by direct puncture is considered useful as a preoperative treatment for venous anomalies.